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From the American Orthopaedic Society for Sports Medicine 2014 Specialty Day

ACL Reconstruction Surgery Puts At Greater Risk Of Osteoarthritis Later in Life, Say Researchers

Teens who have ACL reconstruction are more likely to have arthritis in the knee later in life, say researchers presenting to the American Orthopaedic Society for Sports Medicine's (AOSSM) Specialty Day in New Orleans on March 15, 2014.

"Long-term follow-ups after the surgical treatment of ACL injuries in kids are rare and this is one of the few studies that has been able to track individuals," said Olle Mansson, MD, lead author of the study from NU-Hospital Group in Uddevalla, Sweden. Female soccer player holding teammate's injured knee

The study assessed 32 patients, aged 12-16 years old, 10-20 years after their initial ACL reconstruction that used bone-patellar bone-tendon or hamstring tendon autograft. Twenty-nine patients underwent clinical, radiographical and health-related quality of life assessments after 10-20 years (mean 175 months). The results revealed significant osteoarthritic changes on the reconstructed knee (65%) compared to the non-involved knee (14%). Quality of life and other health related scores were the same or comparable to those seen in healthy controls.

Based on concerns that surgery might damage growth plates at the end of the tibia and fibia in such skeletally immature patients, the optimal initial treatment for ACL injuries in children and adolescents has not resulted in a clear consensus for initial nonoperative treatment or operative reconstruction. 

"Early reconstruction of ACLs is often the trend for young more skeletally mature athletes to restore knee stability and prevent progressive meniscal and/or articular cartilage damage. Often these procedures do allow individuals to return to the playing field and continue an active lifestyle. However, it is still important to evaluate long-term effects such as osteoarthritis when considering surgeries for
these pediatric patients," said Mansson.

The reported long-term risk of osteoarthritis (OA) after ACL injury and subsequent ACL reconstruction varies considerably. Long-term follow-up studies at 6-14 years after ACL injury of both female and male soccer and team handball players reveal high rates of OA and severely impaired quality of life due to knee-related symptoms, problems that effect even young athletes.  

Source: American Orthopaedic Society for Sports Medicine